Būtinybė gauti teismo leidimą civilinėse bylose dėl nepagydomai sergančių pacientų gyvybės palaikymo nutraukimo

The paper presents a comparative analysis of the positions of the courts in respect with the necessity of a court’s authorization to terminate life-support. Some courts hold that it is mandatory in any case, while the other reduce the role of the tribunals only to disputes arising from the decision to withdraw life-support.Straipsnyje pateikiama lyginamoji teismų pozicijų analizė dėl būtinybės gauti teismo leidimą nutraukti gyvybės palaikymą. Kai kurie teismai mano, kad tai yra privaloma bet kuriuo atveju, o kiti sumažina teismų vaidmenį tik ginčuose, kylančiuose dėl sprendimo atsisakyti gyvybės palaikymo

Biotransformation von langkettigen Fettsäuren im Blut und Oxylipinen in peripheren Geweben während der Hämodialyse

Background: Cardiovascular disease (CVD) is the most common lethal complications in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). The role of long-chain fatty acids (LCFAs) and their oxylipin derivatives is poorly understood in human cardiac and renal diseases. Based on previous scientific findings, there is evi-dence that many substance profiles of blood LCFAs and their oxylipin derivatives are altered in dialysis patients and influenced by extracorporeal circulation. In order to pro-vide novel insights into biotransformation and/or bioaccumulation of these metabolites in peripheral tissue, we conducted a targeted lipidomic study and tested the hypothesis that arterio–venous (A–V) differences in blood LCFAs and oxylipins are present in vivo and sensitive to single HD treatment. Methods: We took arterial and venous blood samples specimens from ESRD patients (n=12) before and after HD and determined LCFAs and its derived epoxy and hydroxy metabolites in plasma and erythrocytes by high-performance liquid chromatography with mass spectrometry coupling (HPLC-MS). Results: Firstly, we found that the total amount of numerous saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) in erythrocytes showed negative arteriovenous (AV) differences before HD, which disappeared after HD. The omega-3 index in erythrocytes did not show arteriove-nous differences before and after HD. No significant findings were observed in LCFAs in plasma. Beyond that, all CYP epoxy metabolites in the plasma showed negative arterio-venous differences, mainly due to their significantly elevated levels in venous blood af-ter dialysis. No changes were observed in LOX and LOX/CYP ω/(ω-1)-hydroxylase me-tabolites in the plasma before and after dialysis. This variation in epoxide metabolites may be attributed to a decrease in soluble epoxide hydrolase (sEH) activity. Conclu-sions: Our findings indicate that AV differences in LCFAs are present and active in ma-ture red blood cells (RBCs) and that their bioaccumulation is susceptible to a single HD therapy [1]. HD treatment changes CYP epoxy metabolites from PUFAs in the plasma (accumulation), which may have deleterious effects on the circulation [2].Hintergrund: Herz-Kreislauf-Erkrankungen (CVD) sind eine der häufigsten tödlichen Komplikationen bei Patienten mit terminaler Niereninsuffizienz (ESRD), die sich einer Hämodialyse (HD) unterziehen. Die Rolle der langkettigen Fettsäuren (LCFAs) und ihrer Oxylipinderivate bei Herz- und Nierenerkrankungen des Menschen ist nur unzureichend geklärt. Ausgehend von früheren wissenschaftlichen Erkenntnissen gibt es Hinweise darauf, dass viele Substanzprofile der langkettigen Fettsäuren und ihrer Oxylipinderi-vate im Blut von Dialysepatienten Veränderungen aufweisen und durch den extrakorpo-ralen Kreislauf beeinflusst werden. Um neue Erkenntnisse über die Biotransformation und/oder Bioakkumulation dieser Metaboliten im peripheren Gewebe zu gewinnen, ha-ben wir eine gezielte Lipidomstudie durchgeführt und die Hypothese getestet, ob arteri-o-venöse (A-V) Unterschiede in den LCFAs und Oxylipinen im Blut in vivo vorherrschen, und ob sie auf eine einzelne HD-Behandlung reagieren. Methoden: Wir haben arterielle und venöse Blutproben von Patienten mit terminaler Niereninsuffizienz (n=12) vor und nach der Hämodialyse entnommen und LCFAs und davon abgeleitete Epoxy- und Hyd-roxy-Metaboliten im Plasma und in den Erythrozyten durch Hochleistungsflüssigkeits-chromatographie mit Massenspektrometrie-Kopplung (HPLC-MS) bestimmt. Ergebnis-se: Erstens stellten wir fest, dass die Gesamtmenge zahlreicher gesättigter Fettsäuren (SFAs), einfach ungesättigter Fettsäuren (MUFAs) und mehrfach ungesättigter Fettsäu-ren (PUFAs) in den Erythrozyten vor der HD negative arteriovenöse Unterschiede auf-wiesen, die nach der HD verschwanden. Der Omega-3-Index in den Erythrozyten wies vor und nach der HD keine arteriovenösen Unterschiede auf. Bei den LCFAs im Plasma wurden keine signifikanten Ergebnisse beobachtet. Darüber hinaus wiesen alle CYP-Epoxid-Metaboliten im Plasma negative arteriovenöse Unterschiede auf, was haupt-sächlich auf ihre signifikant erhöhten Werte im venösen Blut nach der Dialyse zurückzu-führen ist. Bei den LOX- und LOX/CYP ω/(ω-1)-Hydroxylase-Metaboliten im Plasma wurden vor und nach der Dialyse keine Veränderungen beobachtet. Diese Veränderung der Epoxidmetaboliten kann auf eine Abnahme der Aktivität der löslichen Epoxidhydro-lase (sEH) zurückgeführt werden. Schlussfolgerungen: Unsere Ergebnisse deuten darauf hin, dass A-V Unterschiede in LCFAs in reifen roten Blutkörperchen vorhanden und aktiv sind und dass ihre Bioakkumulation für eine einmalige HD Therapie anfällig ist [1]. Die HD Behandlung verändert die CYP-Epoxy-Metaboliten von PUFAs im Plasma (Akkumulation), was sich nachteilig auf den Kreislauf auswirken kann [2]

Article 51 Self-Defense as a Narrative: Spectators and Heroes in International Law

The subsequent three parts of this article take the following form. Part II introduces Article 51. Part III considers the manner in which Article 51 produces a narrative of spectatorship for the West. I draw on Al-Radi\u27s narrative to highlight the massive gap between the narratives of Article 51, as it is perceived in mainstream academic accounts of Operation Desert Storm, and the reality of living with the consequential force. I am particularly concerned with the legal features of proportionality, collective self-defense, and the state as a self defending. In Part IV, I use the work of Mclnnes, Orford, and Salecl to demonstrate how the West use a form of self-projection to become both spectator and hero in internal cultural narratives. Drawing on the methodology developed by Gunning, I attend to the inherent essentialism of these narratives rather than attempting to offer alternative non-Western narratives. Finally, in Part V, I return to the force/violence distinction contained in Article 51. How does this regulator of force as legal, and violence as illegal, interact with recent claims that there is also legitimate force that can be used, for example, to halt humanitarian crises? I take the words of Arendt and question the shift from force as justified to force as legitimate, to conclude with further questions about emerging narratives of force that currently preoccupy Western cultures.\u2

Battered Women and Mandatory Minimum Sentences

The author argues for the repeal of mandatory minimum sentences based upon their role in the distortion of defences available to battered women on trial for the homicide of their violent mates. After reviewing other legal strategies aimed at eliminating the discriminatory biases facing women who attempt to plead self-defence, and illustrating the ways in which defences to murder are distorted, she turns to the examination of the transcript of a recent murder trial for a woman who argued self-defence. The author uses the transcript to provide concrete illustrations of three ways in which self-defence is distorted by the mandatory life sentence for murder. She considers prosecutorial guidelines as another possible legal strategy, but concludes that nothing short of repeal of the mandatory life sentence can redress the power imbalance between prosecutor and accused and provide battered women with an opportunity to proceed to trial and have their actions recognized as justified by way of self-defenc

“That Time of Month:” Premenstrual Dysphoric Disorder in the Criminal Law-Another Look

Abstract: This paper argues that women suffering from pre-menstrual dysphoric disorder (PMDD) ought to have available to them a range of legal defences that accurately reflect culpability. As PMDD focuses primarily on emotional mood and behavioural symptoms as opposed to physical manifestations of the premenstrual period, legal treatment of PMDD can be usefully compared to other “disordered states“ that affect mental capacity, rationality and intent. Evolution of PMDD as a distinctive form of psychiatric disorder warrants a new consideration of the dual feminist concerns about the invisibility of women in criminal law theory and the undue labeling of all women. This article considers the application of criminal law defenses in light of newer research characterizing pre-menstrual mental disorder as a dynamic psychiatric and physiological state with shifting determinants that may be experienced differently over time. Ultimately, criminology must grapple with developing an account of women's criminality that reflects accurately women's lives lived within the sometimes overwhelming experience of biopsychosocial stressors. Reviewing PMDD in light of these concerns supports an enhanced understanding of the dynamics between women's mental health and culpability